Fractures, Bone Clinical Trial
Official title:
The Association Between Exposure to Spironolactone or Amiloride and Fracture Risk Among Subjects Treated With Thiazolidinediones
Treatment with thiazolidinediones (TZD) has recently been reported to possibly increase the
risk of fractures in a randomized trial exploring the efficacy of rosiglitazone (RSG),
metformin, or glyburide encompassing 4360 patients with type 2 diabetes.
It is hypothesized that spironolactone, a diuretic that is broadly used for the treatment of
fluid retention and edema associated with TZD, has a potential protective effect against
bone fractures. However, to our knowledge, this has not been tested in diabetic patients
treated with TZD. Amiloride is another diuretic that shares with spironolactone the anti
mineralocorticoid ion gated channels activity and will be analysed in this study with regard
to possible protective effect against bone fracture in combination with TZD.
This study is a nested case-control study conducted among type 2 diabetes subjects exposed
to TZD. The study aims to explore if the risk of fracture is reduced among type 2 diabetic
subjects exposed to spironolactone and TZD. The study will compare the odds of any low
impact fracture, and hand, foot, upper arm, wrist, and hip fracture incidence in subjects
treated with TZD+spironolactone and TZD+amiloride compared to subjects treated with TZD
only.
The study population will consist of type 2 diabetes patients aged 18 -65 years old exposed
to TZD. To be eligible for the study, a subject must have had at least one International
Classification of Disease (ICD)-9 code for type 2 diabetes and have at least 6 months or at
least 12 months of exposure to TZD (rosiglitazone [RSG], pioglitazone [PIO] or troglitazone)
during their follow-up time available in the database.
Patients were not recruited for nor enrolled in this study. This study is a retrospective observational study. Data from medical records or insurance claims databases are anonymised and used to develop a patient cohort. All diagnoses and treatment are recorded in the course of routine medical practice. ;
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